A comparative study to evaluate the efficacy and safety of Dexmedetomidine and Propofol for Sedation in Neurosurgical patients requiring short term Postoperative Mechanical Ventilation

Sheikh Irshad Ahmad; Aayushi Mahajan; Tantry Tariq Gani; Imtiaz Naqash; Tanveera Gani

Volume : IX, Issue : VIII, August - 2020

A comparative study to evaluate the efficacy and safety of Dexmedetomidine and Propofol for Sedation in Neurosurgical patients requiring short term Postoperative Mechanical Ventilation

Sheikh Irshad Ahmad, Aayushi Mahajan, Tantry Tariq Gani, Imtiaz Naqash, Tanveera Gani

Abstract :

Background: Neurosurgical patients requiring short term postoperative mechanical ventilation frequently need sedatives and analgesics to facilitate their care. Aim: The present study compared the efficacy of dexmedetomidine and propofol for sedation in neurosurgical patients for postoperative mechanical ventilation. Design: Prospective randomised study. Materials and Methods: 60 patients of either sex, aged 18 to 60 years, ASA physical status I or II, preoperative GCS 15, undergoing neurosurgery and requiring short term postoperative ventilation were included. The patients were randomly divided into two groups of 30 each. Group I received dexmedetomidine 1 μgkg–1 over 10 minutes followed by maintenance infusion at a rate of 0.2–0.5 μgkg–1hr–1. Group II received propofol as a bolus of 1 mgkg–1 initially, followed by an infusion of 0.5–1 mgkg–1hr–1. Additional analgesia, if required, was provided by fentanyl infusion. Heart rate, mean arterial pressure, central venous pressure, oxygen saturation, sedation level , fentanyl requirement, ventilation and extubation time were recorded. Results: Adequate sedation level was achieved with both drugs. Ramsay sedation score was 3.88 � 0.39 and 4.04 � 0.47 for dexmedetomidine and propofol, respectively, (p=0.152). Total fentanyl dose in the dexmedetomidine group was 33.5 � 7.51 μg compared to 72.2 � 18.15 μg in the propofol group, (p<0.05). Patients who received dexmedetomidine infusion had significantly lower heart rates compared to patients who received propofol infusion, (p<0.05). No difference was found in mean arterial pressures of two groups. Extubation times were similar and rapid with the use of both sedative agents (27.4 � 9.53 minutes for Group I and 30.36 � 10.66 minutes for Group II, p>0.05). No adverse events related to sedative infusions occurred in either group. Conclusion: Dexmedetomidine is safe and equally effective agent compared to propofol for sedation of neurosurgical mechanically ventilated patients with good hemodynamic stability and extubation time as rapid as propofol.